Provider Demographics
NPI:1417061334
Name:LASZLO, MAURICE H (MD)
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:H
Last Name:LASZLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8755 NW 36TH ST
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2401
Mailing Address - Country:US
Mailing Address - Phone:305-935-7141
Mailing Address - Fax:305-935-5018
Practice Address - Street 1:8755 NW 36TH ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2401
Practice Address - Country:US
Practice Address - Phone:305-935-7141
Practice Address - Fax:305-935-5018
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME7097207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL90265AMedicare ID - Type Unspecified